| NPI | 1033305891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LEIDER Clinic Director 718-918-3669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 261QM0801X) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2007-09-14 |